Over time, your routine will start to return to normal. However, it is important
to remember that your immune system will always be somewhat suppressed. We've
tried to include some healthy hints for you as a new transplant recipient. These
guidelines are simply common sense, so don't be paranoid about what you can
and cannot do - just be careful. If you ever have any doubts about an activity,
you know what to do - right? Call your transplant team first.

As a recipient you will be reminded to eat, in moderation, and correctly ("You
are what you eat") and to walk or exercise the equivalent of up to 6 miles per
day. You will be instructed to avoid contact with people who are ill, in your
home, place of work, or elsewhere. To put it bluntly, avoid those who are sneezing
and/or coughing. Your immune system is compromised, and always will be.
The "common cold" can cause you a fairly serious medical problem. The main point
here is to remain alert and aware, and don't be afraid to ask. And don't be
afraid to avoid ill people if you have a question. One recipient left his place
of employment for several days after his boss, who was old enough to know better,
came to work with chicken pox, and wouldn't go home.

Buy and wear a Medic-Alert (or similar) necklace or bracelet. Carry a card
in your wallet or purse stating that you are a transplant recipient and list
all of your daily meds, as well as any known drug allergies.

All programs recommend that you always use a high SPF rated sun
lotion. Immunosuppressive drugs can make you vulnerable to sunburn and increase
your risk of developing skin cancer. Cover up, use a sunscreen of at least
SPF30 and limit your exposure to the sun. Ratings of up to SPF55 have been
quoted to particular individuals as a protection against skin cancer. You
now have a healthy organ or tissue. Protect it! Your post transplant medications
cause you to be supersensitive to sunlight. Stay out of the sun - use a sunscreen!
wear a hat or cap! wear long sleeved shirts and pants while out in the sun!
Avoid going out in the mid-day sun when reasonably possible to do so.

Buy anti-bacterial soap and put it everywhere. Wash your hands often and
make sure your family does too. Buy some anti-bacterial wipes and keep them
handy for times when you are away from the house.

Replace your normal household cleaning products with a brand that disinfects
as well as cleans (e.g., Lysol).

Be very careful around diapers. Better yet, have someone else change the
kids/grandkids.

Travel tips. These are important enough to repeat here!

NEVER pack your meds - carry them with you at all times. You should also
take an extra two weeks supply. That should be enough to cover most emergencies.

Carry a copy of your medical history, doctors' names and phones and a copy
of your prescriptions with you.

Recipients who travel should be very much aware of water safety. Do
not drink local water if there is any question. Bad water that causes
others a severe case of cramps or diarrhea can be downright deadly to the
recipient on immunosuppressive drugs. When traveling, many drink coffee or
any drink that requires boiling of the water. Commercial fountain sodas and
other bottled drinks are oftentimes made from local water. Some patients carry
a portable filter obtained from camping stores. These cost anywhere from $140
to $300 and also require replacement of a filter cartridge.

Enjoy food - but do so in moderation. Remember, it is much easier to gain
weight than to lose it later. If you have questions about weight management,
see a nutrition expert, such as a registered dietitian. You may also call
the National Center for Nutrition and Dietetics at (800) 366-1655 for answers
to any nutrition related questions or to locate a registered dietitian in
your area.

Food safety is important:

Wash your hands before and after handling food, and consider using latex
gloves when handling raw meat.

Wash all fruits and vegetables. One drop of a mild soap in water will wash
away most pesticides and germs.

NEVER, EVER eat raw seafood or meat.

Never eat an egg unless it has been cooked solid. Avoid food made with
raw eggs such as Caesar salad, homemade ice cream, Hollandaise sauce and eggnog.

In restaurants, avoid salad bars and buffet tables where food may be kept
at inadequate temperatures.

Order your meats cooked "well-done".

Exercise regularly. Begin with short, easy workouts with an activity you
enjoy and progress at your own pace. Talk to your doctor before starting any
new vigorous exercise routine.

Consider using bottled water or a water filter for drinking water and ice.
If you use a filter, make sure it meets ANSI/NSF standard 53 for filtering
out Cryptosporidum, etc. Also see note under travel tips, above. For a list
of products that are certified to NSF standard 53, write to:
NSF International
P.O. Box 130140
Ann Arbor, MI 48113-0140
800-NSF-MARK / 800-673-6275

Pets are OK too, BUT use caution:
Especially with cats and litter boxes; cat feces can carry toxoplasmosis.
Dogs are OK, but stay away from the feces. Dogs also like to eat cat feces,
so keep an eye on Fido.
Birds carry many parasites and bacteria - use caution. (Lung transplants -
stay away!)
Stay away from hamsters, gerbils, mice and rats - bites can be a problem.
Iguanas and turtles can carry salmonella.

All programs recommend the annual flu shot, and most also strongly recommend
any vaccinations that were missed when you were a candidate. Caution: Avoid
live virus vaccinations.

Many recipients are encouraged by their transplant team to take multiple or specific
vitamins and mineral supplements. Common "suggestions" include:

Calcium For bone loss, as a side effect of prednisone.

Magnesium For bone loss, assists absorption of calcium.

Zinc Boosts immune system, for memory loss.

Garlic Boosts immune system, lowers blood pressure.

Vitamin B-6 For tremors as a side effect of Prograf, also helps teeth and
gums.

Vitamin C Boosts immune system, also helps bones and teeth.

Vitamin D Enhances absorption of calcium.

Vitamin E Boosts immune system, helps heart and skeletal muscles.

Before taking any vitamin or mineral supplement, discuss it with your transplant
team. Your prescribed medications will affect their recommendations. Some transplant
coordinators leave these decisions entirely to the individual recipient's discretion
because of cost considerations.

All programs, however, agree that patients on prednisone need calcium in their
diet and/or mineral supplements. At least one program recommends TUMS as a source
of calcium.

The Cost Containment Research Institute has published a booklet entitled "A
Guide to Vitamins and Minerals." Provides information about the effects and
benefits of most vitamins and minerals. To receive a copy send $5.00 to cover
postage and handling to: The Institute, Booklet #MV907, 611 Pennsylvania Ave.
SE, Suite 1010, Washington, DC, 20003-4303. 202-637-0038, http://www.institute-dc.org/